OR1-8 | Ultrathin Biodegradable-Polymer vs Durable-Polymer Drug-Eluting Stents: A Meta-Analysis of Randomized Trials

Background: Patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) remain at high risk for adverse cardiovascular outcomes.Tirzepatide, a dual GIP/GLP-1 receptor agonist, has demonstrated metabolic and cardiovascular benefits; however, its impact on post-PCI outcomes is not well defined.We evaluated the association between tirzepatide use and clinical outcomes following PCI in patients with DM Methods: We conducted a retrospective cohort study using the Tri-NetX Network.Adult patients with DM who underwent PCI were identified and stratified by tirzepatide exposure.Propensity score matching (1:1) was performed to balance baseline characteristics, yielding 2,076 patients per cohort.Mean follow-up after matching was approximately 1 year.Outcomes included all-cause mortality, repeat myocardial infarction (MI), stroke, major adverse cardiovascular events (MACE), acute decompensated heart failure (ADHF), acute kidney injury (AKI), and in-stent restenosis (ISR).Risk ratios, hazard ratios, and Kaplan-Meier survival analyses were performed.Results: After propensity matching, baseline follow-up duration was comparable between cohorts.Tirzepatide use was associated with significantly lower all-cause mortality compared with non-use (2.9% vs 7.7%; risk ratio [RR] 0.38, 95% CI 0.29-0.51;hazard ratio [HR] 0.39, 95% CI 0.29-0.52;log-rank p<0.001).Tirzepatide was also associated with reduced risks of repeat MI (18.2% vs 25.5%; HR 0.67, 95% CI 0.59-0.77),stroke (5.0% vs 7.2%; HR 0.69, 95% CI 0.54-0.89),and MACE (35.6% vs 48.7%; HR 0.66, 95% CI 0.60-0.73),all p<0.01.Additionally, tirzepatide users experienced lower rates of ADHF (39.4% vs 46.3%; HR 0.78, 95% CI 0.71-0.86),AKI (14.4% vs 21.1%; HR 0.66, 95% CI 0.57-0.77),and ISR (7.7% vs 9.9%; HR 0.78, 95% CI 0.64-0.96)Conclusions: In this large, real-world, propensity-matched analysis, tirzepatide use in patients with DM undergoing PCI was associated with significantly lower all-cause mortality and reduced risks of ischemic events, heart failure, renal complications, and restenosis.These findings highlight a potential cardioprotective effect of tirzepatide in high-risk post-PCI diabetic patients.